Starting Your Patient on Cibinqo? A Simple Guide for Quick Access

Shannon E. Epling MSc, Pharmaceutical Sciences Date: 07/16/2024

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Cibinqo Enrollment Forms   


Pfizer’s FDA-approved Cibinqo (abrocitinib) is a medication used to treat moderate to severe atopic dermatitis in adults and teens over the age of 12. It works by blocking a specific protein in the immune system that contributes to inflammation. Cibinqo is given as a tablet that is taken orally. The dosing frequency and amount of medication will depend on the patient's condition and response to treatment.

However, as a healthcare provider, obtaining access to Cibinqo enrollment forms can be time-consuming and confusing. In this article, we will provide you with access to Cibinqo enrollment forms and introduce you to the Pfizer Dermatology Patient AccessTM Program – which provides a variety of HCP and patient resources to streamline the process of prescribing Cibinqo to treat patients.

Download Cibinqo Enrollment Forms

Get  Cibinqo enrollment forms to get your patients started on treatment.

Accessing Cibinqo Enrollment Forms

To obtain Cibinqo enrollment forms, you can download the PDF for adults available here. Providers can also visit the Cibinqo Website which contains a variety of resources for healthcare providers and patients to manage treatment with Cibinqo. 

Once you have obtained and accurately completed the Cibinqo enrollment forms with your patient’s information, the enrollment forms can be submitted to the appropriate parties. Cibinqo enrollment forms require information about your patient’s medical history, insurance coverage, treatment history and the reason for prescribing Cibinqo. 

To enroll your patient in the Pfizer Dermatology Patient AccessTM Program for prescription management and support, fax the completed enrollment form to 1-877-548-1734. Patients can also enroll themselves in the program via the Pfizer RxPathwaysTMwebsite

Pfizer Dermatology Patient AccessTM Program

The Pfizer Dermatology Patient AccessTM Program is a patient support program offered by Pfizer, the manufacturer of several medications used to treat dermatological conditions. The program is designed to provide patients with resources and support to help manage their condition and treatment.

Some of the benefits of the Pfizer Dermatology Patient AccessTM Program include:

  • Financial assistance: The program offers financial support to eligible patients, including co-pay assistance and reimbursement support.
  • Educational resources: The program offers educational resources to help patients better understand their condition and treatment, including brochures, videos, and webinars.
  • Nurse support: The program provides access to a nurse who can answer questions about Pfizer's medications and provide guidance on managing treatment.
  • Referral to local resources: The program can connect patients to local resources, such as support groups and advocacy organizations.

Enrolling in the Pfizer Dermatology Patient AccessTM Program is easy and can be done online by completing the enrollment form and faxing to 1-877-548-1734. Once enrolled, patients have access to a range of resources and support services to help them manage their condition and stay on track with their treatment plan. The program is available to patients who have been prescribed a Pfizer dermatological medication by their healthcare provider and meet certain eligibility criteria. 

Conclusion 

As a healthcare provider, it can be challenging and time-consuming to navigate access to Cibinqo enrollment forms. This blog provides you access with the appropriate enrollment forms and the information to help support patients as you manage their condition. 


With the aid of the Pfizer Dermatology Patient AccessTM Program, you can gain access to resources and support to help streamline the process of prescribing to ensure that your patients receive the medications they need, when they need them. By utilizing the resources available through the program, you can confirm that your patients receive the best possible care for their autoimmune disorders. 

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